Platelet autologous plasma for the treatment of posttraumatic osteoarthritis and knee injury: clinical findings of 12 months follow-up

Abstract

Osteoarthritis (OA) is the most common form of arthritis in the world. In the general structure of morbidity, the portion of OA is 12%. The main reason for the development of secondary knee OA in young patients is traumatic injury, which leads to the gradual degradation of the articular cartilage with the development of symptomatic OA in the first 3-5 years after injury.The objective: to investigate the clinical safety and efficacy of platelet autologous plasma (PAP) comparing to standard treatment in young patients with symptomatic post-traumatic knee OA (PTOA) and in the early period after the knee injury.Materials and methods. The stady included 122 patients (mean age 34,81±4,28 years), 62 – with established symptomatic PTOA (mean time from trauma –46,87±2,09 months), and 60 – in early period after intra-articular knee trauma (confirmed by MRI, 20,15±1,72 days after injury). Patients with established PTOA and knee trauma were divided in 2 groups – Gr.1 received standard treatment (NSAIDs, exercises, complex physical therapy for patients with PTOA and NSAIDs, complex physical therapy for patients with knee trauma), Gr.2 –in addition to the standard treatment received course of 3 intra-articular injections of PAP. Efficacy of treatment in both group was evaluated by standard recommended scales (KOOS questionnaire (Knee injury and Osteoarthritis Outcome Score) and VAS pain score (Visual Analogue Scale).Results. Patients of both groups with PTOA demonstrated positive dynamics of clinical manifestations of OA and functional activity, which affected the improvement of KOOS parameters. However, Gr.2 showed better results compared to Gr.1. During the follow-up period, in both groups of patients with knee injury, positive dynamics were observed for all KOOS subscales. However, the functional state of patients who received intraarticular PAP injection had a more significant dynamic, accompanied by significant differences in indicators with repeated monitoring.Conclusions. Use of the intraarticular injections of PAP for the treatment of symptomatic knee PTOA, as well as in the early period after a knee injury is safe and effitient part of the complex therapy, which improves both early and long-term results of the treatment. In patients with PTOA, PAP use allows to reduce the number of exacerbations arthritis within 12 months. In patients after knee trauma PAP use accelerates the improvement in the functional activity comparing to treatment with standard therapy.